Permit CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2008 -00202
° COMMUNITY DEVELOPMENT DATE ISSUED: 4/8/2008
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 1S135DC-00700
SITE ADDRESS: 11870 SW LINCOLN AVE ZONING: R -7
SUBDIVISION: TIGARDVILLE PARK LOT : 008 JURISDICTION: TIG
PROJECT: NASS
Project Description: Installing (3) branch circuits.
RESIDENTIAL UNIT TEMP SRVC /FEEDERS MISCELLANEOUS
1000 SF OR LESS: 0 - 200 amp: PUMP /IRRIGATION:
EACH ADD'L 500SF: 201 - 400 amp: SIGN /OUT LINE LTG:
LIMITED ENERGY: 401 - 600 amp: SIGNAL/PANEL:
MANF HM/ SVC/ FDR: 601 +amps -1000 volts: MINOR LABEL (10):
SERVICE/FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS
0 - 200 amp: W /SERVICE OR FEEDER: PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: 1 PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: 2 IN PLANT:
601 - 1000 amp: PLAN REVIEW SECTION
1000+ amp /volt: > =4 RES UNITS: > 600 VOLT NOMINAL:
Reconnect only: SVC /FDR >= 225 AMPS: CLASS AREA/SPEC OCC:
Owner: Contractor:
KRAIG NASS BEAR ELECTRIC
11870 SW LINCOLN AVE P.O. BOX 389
TIGARD, OR 97223 DONALD, OR 97020
Phone: 503 - 267 -2265 Contact #: PRI 503- 678 -1355
FAX 503- 678 -1108
FEES
Description . Date Amount Reg #: ELE 24 - 107C
[ELPRMT] ELC Permit 4/7/2008 $60.15 LIC 20919
[TAX] 12% State Surchar 4/7/2008 $7.22 SUP 4902S
• Total $67.37 REQUIRED ITEMS AND REPORTS
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. All
work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for
more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in
OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at 503.246.6699 or 1.800.332.2344.
Issued By: �� Permittee Signature: .YrCe ' - 47,
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: DATE:
LICENSE NO:
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
04/07/2008 MON 15:20 FAX 5036781108 Bear Elec 1c,Inc. a001/002
60 •
Electrical Permit ApplicatiT_ FOR OFFICE ISE ONLY
•
City of Tigard
1 i
9 t4ed. V 7 at Ac - ' conic No.: . E . L ... 0 ),c 0 y -- 1
4,0
.1 . 13125 SW Hall Blvd.. Tigard, OR 97223 ‘
.102 - w
1 2 Phone: 503.639.4171 Fax: 503.598.1960 Other Permit
01 1 ‘ Y '
■I .... ^ , Date Readray: Saris: Ild See Page 2 for
'TIGARD Inspection Line: 503.639.4175
Internet: www.tigard-or.gov .
CZ 1 %AG NJ Notified:Method: Supplemental Information
• • •• . - ''' '• • ' : '-':..' . -- ' tYPe of *etiii0 ' ElE
0 New construction ...Addition/alteration/replacement Please check all that apply (submit sets of plans witems checked below):
0 Service or feeder 400 amps or more 0 Building over three stories.
El Demolition ' 0 Other: where the available fault current 0 Marinas and boatyards.
- , - ' ' ' ' : . ' •-' . ' • . . P gEMMOPPTON . , :: . ' • -.:: -'., :. .. • exceeds 10.600 amps at ISO volts or 0 Floating buildings.
''. . '' ' • •• ' • '' ' - ' - - • ' - '-' - ' ''' - • '. ' •••••'''• ' '•' less to ground. or exceeds 14.000 0 Commercial agricultural
K i_ and 2-family dwelling 0 Commercial/industrial 0 Accessory building amps for all other installations. buildings. •
0 Multi-family 0 Master builder 0 Other: 0 Fire pump. 0 Installation of 75 KVA or
joileide itimbidaiiiiik :kit,- :LOCATION . - ::.:,,: -:,,,. 0 Emergency system. larger separately derived system.
Job no.: Job site address: L A's, 100HP or more.
0 Six or more residential units. occupancy.
0 Recreational vehicle parks.
City/StaterDP:Tic , 31/4cv . c ri c)Q Q\ 27 0 Health.care facilities. ' 0 Supply voltage for more than
I 0 Hazardous locations. 600 volts nominal.
• Suite/bldg./apt. no.: `') I Project name: l' 0 Service or feeder 600 amps or more.
.:•.:::• •. .: ,!: :::.• 'S.:'f ..,.' - .: : :,: ', i
Cross street/directions to job site: %k A O rejeje)busSa Demiption I Qty. I Fee. 1 Total . 1 .•
New residential single- or multi-family dwelling unit.
ne.06.K-_CICA \A) Includes attached garage.
Subdivision: I Lot no.: I sq. ft. or less 145.15 4
Ea. add'l 500 sq. ft. or portion 33.40 1
Tax map/parcel no.:
....,.., ,, Limited energy, residential
::::i:•-•:•,::'. ift0)50)**.illtit:Ai'.V,;:t Alll ;:i,,3:. with above sq it ) 75.00 2
Limited energy, multi-family
kt ,__.C■gs__NO ciAc K>fce, i _ + IT k residential (with above sq. IL) 75.00 2
Services or feeders installation,alteration, and/or relocation
(\C' NX 1....L\C ( C\ r\ I\CA (ea T'l \ e'-Q. cee..,c 200 amps or less 80.30 2
0 PIO i'Elt.ilt ONVNOt ' ' •.. :-..:- ,• -..- 11. TENANT „. j ,.: . 201 amps to 400 amps ' 106.85 - 2
. . - . .... .
Name: 401 amps to 600 amps 160.60 2
• 601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts 454.65 2
City/State/ZIP: Temporary services or feeders installation, alteration, and/or
relocation
Phone: ( ) I Fax: ( ) 200 amps or less 66.85 I
Owner installation: This installation is being made on property that i own which is not 201 amps to 400 amps 100.30 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 133.75 2
Branch circuits - new, alteration, or extension, per panel
Owner signature: Date: ••
A. Fee for branch circuits with
:.:.. - . • . ... .. - . . 1:11#S4:00'::: : .: '';.4,40ifl"; .:7 above s ervice or feeder fee 6.65 2
each branch circuit .
Business name:
B. Fee for branch circuits .
Contact name: Nh
without service or feeder fee, \
N-c s ,
first branch circuit 46.85 4078 2
Address: .,...c\fle... Each add'I branch circuit 2 6.65 13;30 2
Miscellaneous (service or feeder not included)
City/State/ZIP: Each manufactured or modular
90.90
dwelling, service and/or feeder
Phone: (,503) 21 22(0 I Fax: : ( ) Reconnect only 66.85 2
E-mail: Pump or irrigation circle 53.40 2
53A0 2
. - • . . ,...; -:, . - •:'0 0 0 11 0k . ; - :• . ..ii.. : :. ::•:: . . • . - •::'..:=5:. . .r Sign or outline lighting
Business name: B cot c 1:- VI' C‘.S.:.0 i kT \Q„ Signal circuit(s) or limited-
energy panel, alteration, or
Address: tp ‘ B a n extension. Describe: Page 2 2
City/State/ZIP: C 1O 2c Each additional inspection over allowable in any_of the above
.. Per inspection 62.50
Phone: (.5(4?) 6 - 155 Fax: (5c23) kirk i i? ‘ - no L Investigation per hour (I lv inin) 62.50
CCB Lie.: 20 tct Electrical Lie.: 24-1-10 Suprv. Lic.: 3 (Q
i,s Industrial plant Per hour 73.75
• : ELECIVN; MAW FEES, __, .•
• Suprv. Electrician signature, required: (2,,,64,,,crz,,, Subtotal: WO. },5
Plan review (25% of permit fee):
Print name: C2cadS___ j_ t----O
State surcharge (12% of pennit fee): -- n
Authorized signature: TOTAL PERMIT FEE:
This permit application expires If a permit is not obtained .0 in 180
Print name: _I Dm: days after it has been Mewled as Complete.
---
• Number of inspections allowed per permit.
I Huilihnc Perms 171.c•rotnnApp d 05 C' 55 Jm II oi (0ii wE8
' . .
•
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC200 &00202
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:. 4/8/2008
Phone: (503) 639 - 4171 °W IC h*
Inspection Requests (24 Hrs.): (503) 639 -4175 .
INSPECTION WORKSHEET FOR DATE: 4/11/2008 TIME: 7:01AM PAGE: 14
SITE ADDRESS: 11870 SW LINCOLN AVE CLASS OF WORK:
SUBDIVISION: TI3ARDVILLE PARK LOT #: 008 TYPE OF USE:
PROJECT NAME: NASS
DESCRIPTION: Installing (3) branch circuits.
OWNER: NASS, KRAIG PHONE #: 503 -267 -2265
CONTRACTOR: E3EAR ELECTRIC PHONE #: 5036713 - 1355
Inspection Request Scheduled For: Date: 4/11/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
193 Electrical final 068256.01 503-6713-1355 N
Corrections /Comments/ Instructions:
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WI/ Avkv
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11,0-td L
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e PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: " 11 � X Phone #: (503) 718-
18 VY4